Provider Demographics
NPI:1285049221
Name:PATEL, REENABEN (MD)
Entity type:Individual
Prefix:
First Name:REENABEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23850 VIA ALISOL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-3479
Mailing Address - Country:US
Mailing Address - Phone:347-453-7183
Mailing Address - Fax:
Practice Address - Street 1:36320 INLAND VALLEY DR
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7512
Practice Address - Country:US
Practice Address - Phone:951-696-5837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-28
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174004207R00000X
WI66661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA174004OtherMEDICAL BOARD OF CALIFORNIA